Spinocerebellar ataxia type 17 mutation as a causative and susceptibility gene in parkinsonism

OBJECTIVE

To investigate the role of spinocerebellar ataxia type 17 (SCA17) in the development of parkinsonism.

METHOD

We screened 1,155 parkinsonian patients (931 with Parkinson disease and 224 with multiple system atrophy) and 400 normal subjects for SCA17. 99mTc-TRODAT-1 SPECT was used to evaluate the striatal dopamine transporter (DAT) status.

RESULTS

Trinucleotide expansion in the SCA17 gene was found in 10 parkinsonian patients (8 with Parkinson disease, 2 with multiple system atrophy) using 42 repeats as an upper normal limit. The repeat sizes in the patients ranged from 43 to 46, which are considered to be low-range expansions. All patients had interrupted sequences. Three probands and three asymptomatic carriers underwent 99mTc-TRODAT-1 SPECT. Striatal DAT binding was markedly reduced in all probands and mildly decreased in one asymptomatic carrier. Among the 400 normal control subjects, there was one individual with an expansion of 44 repeats, another with 43 repeats, and two with 42 repeats. Striatal DAT binding was decreased not only in the control subjects with 44 or 43 repeats, but in ones with 42 repeats, suggesting that an expansion as low as 42 repeats might constitute a susceptibility gene for parkinsonism.

CONCLUSIONS

Low-range expansion of the SCA17 gene is not a rare genetic cause of parkinsonism without ataxia in our population. Reduced penetrance or variable expressivity in low-range expansion might be an explanation for the blurred cutoff point for normal expansion in SCA17.

Prevention of propofol-induced pain in children: combination of alfentanil and lidocaine vs alfentanil or lidocaine alone

BACKGROUND

Pain from a propofol injection is a common side-effect in paediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combined pretreatment of alfentanil with lidocaine on the incidence and severity of propofol injection pain in children.

METHODS

After obtaining parental consent, 120 paediatric patients were allocated randomly into one of the three groups (n=40, in each). The patients in the alfentanil group received alfentanil 15 microg kg(-1) 90 s before the propofol injection. The patients in the lidocaine group received propofol 3 mg kg(-1) premixed with lidocaine 0.1% over a 15 s period. The patients in the combination group received both alfentanil and lidocaine.

RESULTS

The incidence of propofol injection pain (severity 2 or more) in the combination group (2.6%) was significantly lower than that in the alfentanil and lidocaine groups (30% and 38.5%, respectively) (P=0.001 and <0.001, respectively). No patient in the combination group complained of moderate or severe pain from propofol injection.

CONCLUSIONS

Our study demonstrated that the combination treatment of two different analgesic modalities, alfentanil and lidocaine, could prevent the moderate and severe pain on propofol injection, and reduce the incidence of mild pain compared with each drug alone.

Post-induction alfentanil reduces sevoflurane-associated emergence agitation in children undergoing an adenotonsillectomy

BACKGROUND

Emergence agitation is a common problem in paediatric anaesthesia, especially after volatile induction and maintenance anaesthesia (VIMA) with sevoflurane. The purpose of this study was to investigate the effect of alfentanil to prevent emergence agitation without delayed recovery after VIMA with sevoflurane in children undergoing an adenotonsillectomy.

METHODS

One hundred and five children, aged 3-10 years, were randomly allocated to receive normal saline (control group), alfentanil 10 microg/kg (A10) or 20 microg/kg (A20) 1 min after loss of the eyelash reflex. Anaesthesia was induced and maintained with sevoflurane. Time to tracheal extubation, recovery time, Paediatric Anaesthesia Emergence Delirium (PAED) scale and emergence behaviour were assessed.

RESULTS

The incidence of severe agitation was significantly lower in the A10 and A20 groups compared with those in the control group (11/32 and 12/34 vs. 24/34, respectively) (P=0.007, 0.006, respectively). PAED scales were significantly different between the three groups (P=0.008), and lower in the A10 and A20 groups than that in the control group (P=0.044, 0.013, respectively). However, the incidence of severe agitation and PAED scale was not different between the A10 and the A20 groups. Time to tracheal extubation and recovery time were similar in all three groups.

CONCLUSION

The administration of alfentanil 10 microg/kg after induction of anaesthesia for children undergoing an adenotonsillectomy under VIMA reduced the incidence of emergence agitation without delaying the recovery time or causing significant hypotension.

Effect of short term calorie restriction on pro-inflammatory NF-kB and AP-1 in aged rat kidney

OBJECTIVE

To compare the effect of short-term calorie restriction (CR) on aging with that of already known long-term CR, the anti-inflammatory efficacy of 10-day CR was explored in aged rat kidney.

TREATMENT

Two different age groups, 6 months (young) and 24 months (old) were used. In the old group, one sub-group was control, fed ad libitum (AL) and the other was fed CR for 10 days with 40 % of the food intake of the AL subgroup (n = 5).

METHODS

Reactive species (RS), lipid peroxides and COX-2 activity were measured. The activities of proinflammatory transcription factors NF-kB and AP-1 were measured by electro-mobility shift assay (EMSA). Upstream signaling cascades of NF-kB and AP-1 as well as proinflammatory gene expression were detected by Western blot.

RESULTS

10-day CR suppressed RS, lipid peroxides, and COX-2 activity in aged rat kidney. CR also inhibited upstream signaling cascades and DNA binding activity of NF-kB and AP-1, and thioredoxin/Ref-1 pathway. CR blocked expression of NF-kB-and AP-1-responsive gene COX-2, iNOS, VCAM-1 and ICAM-1.

CONCLUSIONS

We report for the first time that 10-day CR can attenuate the altered signaling transduction for inflammatory processes which is mediated through RS-induced NF-kB and AP-1 in aged kidney.

Search for proton decay via p-->e+pi0 and p-->micro+pi0 in a large water Cherenkov detector

We have searched for proton decays via p-->e;{+}pi;{0} and p-->micro;{+}pi;{0} using data from a 91.7 kt.yr exposure of Super-Kamiokande-I and a 49.2 kt.yr exposure of Super-Kamiokande-II. No candidate events were observed with expected backgrounds induced by atmospheric neutrinos of 0.3 events for each decay mode. From these results, we set lower limits on the partial lifetime of 8.2 x 10;{33} and 6.6 x 10;{33} years at 90% confidence level for p-->e;{+}pi;{0} and p-->micro;{+}pi;{0} modes, respectively.

An Ecological Perspective on the Media and Youth Development

From an ecological perspective, daily activities are both a cause and a consequence of youth development. Research on youth activities directs attention to the processes through which daily activities may have an impact on youth, including: (a) providing chances to learn and practice skills; (b) serving as a forum for identity development; (c) affording opportunities to build social ties; (d) connecting youth to social institutions; and (e) keeping youth from engaging in other kinds of activities. Youth's daily activities, in turn, both influence and are influenced by the multi-layered ecology within which their lives are embedded, an ecology that ranges from the proximal contexts of everyday life (e.g., family, peer group) to the larger political, economic, legal and cultural contexts of the larger society. The paper concludes with consideration of methodological issues and directions for research on the media and youth development.

Estimation of mass transport parameters of gases for quantifying CH4 oxidation in landfill soil covers

Methane (CH(4)), which is one of the most abundant anthropogenic greenhouse gases, is produced from landfills. CH(4) is biologically oxidized to carbon dioxide, which has a lower global warming potential than methane, when it passes through a cover soil. In order to quantify the amount of CH(4) oxidized in a landfill cover soil, a soil column test, a diffusion cell test, and a mathematical model analysis were carried out. In the column test, maximum oxidation rates of CH(4) (V(max)) showed higher values in the upper part of the column than those in the lower part caused by the penetration of O(2) from the top. The organic matter content in the upper area was also higher due to the active microbial growth. The dispersion analysis results for O(2) and CH(4) in the column are counter-intuitive. As the upward flow rate of the landfill gas increased, the dispersion coefficient of CH(4) slightly increased, possibly due to the effect of mechanical dispersion. On the other hand, as the upward flow rate of the landfill gas increased, the dispersion coefficient of O(2) decreased. It is possible that the diffusion of gases in porous media is influenced by the counter-directional flow rate. Further analysis of other gases in the column, N(2) and CO(2), may be required to support this hypothesis, but in this paper we propose the possibility that the simulations using the diffusion coefficient of O(2) under the natural condition may overestimate the penetration of O(2) into the soil cover layer and consequently overestimate the oxidation of CH(4).

Circulating osteoprotegerin levels are elevated and correlated with antiphospholipid antibodies in patients with systemic lupus erythematosus

Patients with antiphospholipid syndrome (APS) have an increased risk for the development of thrombotic complications. Recent studies indicate that osteoprotegerin (OPG) acts as an important molecule in the development of vascular diseases. The aim of the present study was to examine the association between serum OPG levels and APS manifestations in patients with SLE. Seventy-nine patients with SLE and ninety-two healthy controls, matched for age and sex, were included in this study. Serum levels of OPG, monocyte chemoattractant protein(MCP)-1 and soluble E-selectin were determined by ELISA. At the time of serum sampling, various clinical and laboratory parameters were assessed. We found that serum levels of OPG were significantly higher in patients with SLE than in healthy controls (1236 ± 82 vs 967 ± 37 pg/mL, P = 0.003). Particularly, serum OPG levels were significantly higher in SLE patients with APS than those without (1615 ± 191 vs 1171 ± 91 pg/mL, P = 0.006). Serum OPG levels correlated with titres of IgG anti-cardiolipin antibody ( P = 0.026) and anti-β2-glycoprotein I antibody ( P < 0.001). Moreover, serum OPG also correlated with serum levels of sE-selectin ( P = 0.002), which is an endothelial cell activation marker, and MCP-1 ( P = 0.003), a well known chemokine implicated in thrombogenesis. Collectively, serum OPG levels were increased in SLE patients with APS and correlated with titres of antiphospholipid antibodies, suggesting that OPG might be linked to the development of APS.

Personality and community prevention teams: Dimensions of team leader and member personality predicting team functioning

The predictors and correlates of positive functioning among community prevention teams have been examined in a number of research studies; however, the role of personality has been neglected. In this study, we examined whether team member and leader personality dimensions assessed at the time of team formation predicted local prevention team functioning 2.5-3.5 years later. Participants were 159 prevention team members in 14 communities participating in the PROSPER study of prevention program dissemination. Three aspects of personality, aggregated at the team level, were examined as predictors: Openness to Experience, Conscientiousness, and Agreeableness. A series of multivariate regression analyses were performed that accounted for the interdependency of five categories of team functioning. Results showed that average team member Openness was negatively, and Conscientiousness was positively linked to team functioning. The findings have implications for decisions about the level and nature of technical assistance support provided to community prevention teams.

Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in children

BACKGROUND

Studies comparing epidural fentanyl and sufentanil in adults reported a similar analgesic effect with variable side effects. We hypothesized that epidural fentanyl and sufentanil will have a similar analgesic effect in children undergoing urological surgery.

METHODS

Sixty-four children undergoing urological surgery were randomized into two groups: fentanyl in ropivacaine (fentanyl group, n=32) and sufentanil in ropivacaine (sufentanil group, n=32). After anaesthesia, an epidural catheter was inserted at the L2-3, L3-4 or L4-5 interspace. For post-operative pain relief, a solution consisting of fentanyl 0.1 mcg/kg/ml or sufentanil 0.015 mcg/kg/ml in 1.5 mg/ml ropivacaine was infused at a rate of 2 ml/h. To assess post-operative pain, the faces pain scale and the face, legs, activity, cry, consolability score were recorded at 1, 6, 24, 48 and 72 h after surgery. The incidence of adverse effects such as hypoxia, sedation, pruritus, nausea and/or vomiting was also evaluated.

RESULTS

Pain scores demonstrated no significant difference between the groups. The need for rescue analgesia during 24-72 h was higher in the fentanyl group than in the sufentanil group (6/32 vs. 0/32, P=0.012). The incidence of pruritus was higher in the sufentanil group compared with that in the fentanyl group (5/32 vs. 0/32).

CONCLUSIONS

Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in infants and children undergoing urological surgery. The incidence of pruritus in the sufentanil group was higher than that in the fentanyl group.

Inclusive K(S);(0)K(S);(0) resonance production in ep collisions at HERA

Inclusive K_{S};{0}K_{S};{0} production in ep collisions at the DESY ep collider HERA was studied with the ZEUS detector using an integrated luminosity of 0.5 fb;{-1}. Enhancements in the mass spectrum were observed and are attributed to the production of f_{2}(1270)/a_{2};{0}(1320), f_{2};{'}(1525) and f_{0}(1710). Masses and widths were obtained using a fit which takes into account theoretical predictions based on SU(3) symmetry arguments, and are consistent with the Particle Data Group values. The f_{0}(1710) state, which has a mass consistent with a glueball candidate, was observed with a statistical significance of 5 standard deviations. However, if this state is the same as that seen in gammagamma-->K_{S};{0}K_{S};{0}, it is unlikely to be a pure glueball state.

Electro-fluorescence switching of bis-imidazolium ionic liquids

Room-temperature ionic liquids (RTILs) containing bis-imidazolium salts were explored to control their optical properties of them in an organic device. The neat bis-imidazolium salts showed ionic conductivity of 3.5 x 10(-4) S/cm at room-temperature and the electrochemical window was exhibited within +/-2.5 V in a two electrode cell. The bis-imidazolium salts were transparent yellow and showed fluorescence upon excitation with light in the range of 360 to 500 nm. A two electrode organic ionic liquid cell was fabricated using a mixture of PEO200Blm-TFSI and electroactive molecules to control the emission property of the ionic liquid by electrochemical methods. The first example of the ionic liquid containing electro-fluorescence switch was explored with an electroactive benzyl viologen (BzV) blend of bis-imidazolium ionic liquid.

Cultural orientations, daily activities, and adjustment in Mexican American youth

The links between youth's daily activities and adjustment and the role of cultural practices and values in these links were studied in 469 youth from 237 Mexican American families. In home interviews, data on mothers', fathers', and two adolescent-age siblings' cultural practices (language use, social contacts) and values (for familism, for education achievement) were collected, along with data on youth risky behavior and depressive symptoms. In 7 nightly phone calls, youth reported on their day's free time activities (i.e., sports, academics, religious activities, television viewing, and hanging out). Analyses revealed that youth who spent more time in unsupervised hanging out reported more depressive symptoms and risky behavior, and those who spent more time in academic activities reported less risky behavior. Results also indicated that more Anglo-oriented youth spent more time in sports, that more Mexican-oriented youth spent more time watching television, that fathers' familism values were related to youth's time in religious activities, and that parents' educational values were linked to youth's time in academic activities. Some evidence indicated that parents' cultural practices and values, particularly fathers', moderated the links between daily activities and youth adjustment.

The optimum bolus dose of remifentanil to facilitate laryngeal mask airway insertion with a single standard dose of propofol at induction in children

The purpose of this study was to determine the optimal bolus dose of remifentanil required for the successful insertion of the laryngeal mask airway during propofol induction in children without a neuromuscular blocking agent. Twenty-six paediatric patients, aged 3-10 years, requiring anaesthesia for short ambulatory surgery were recruited. A predetermined bolus dose of remifentanil was injected over 30 s, followed by propofol 2.5 mg.kg(-1) over 10 s. The bolus dose of remifentanil was determined by a modified Dixon's up-and-down method, starting from 0.5 microg.kg(-1) (0.1 microg.kg(-1) as a step size). Laryngeal mask insertion was attempted 90 s after the end of remifentanil injection and the response of patients was classified as either 'movement' or 'no movement'. The bolus dose of remifentanil at which there was a 50% probability of successful laryngeal mask insertion (ED(50)) during induction with 2.5 mg.kg(-1) propofol was 0.56 (0.07) microg.kg(-1) in children without a neuromuscular blocking agent. From probit analysis, the ED(50) and ED(95) of remifentanil were 0.52 microg.kg(-1) (95% confidence limits, 0.42-0.62 microg.kg(-1)) and 0.71 microg.kg(-1) (95% confidence limits, 0.61-1.40 microg.kg(-1)), respectively.

The effect of lidocaine on remifentanil-induced cough

This study was performed to investigate the incidence of remifentanil-induced cough and evaluate the efficacy of lidocaine on its prevention. Five-hundred patients, aged 18-70 years, were randomly allocated into two groups to receive either lidocaine 0.5 mg x kg(-1) or 0.9% normal saline intravenously 1 min before remifentanil administration at a target effect-site concentration of 4 ng x ml(-1). Any episode of cough was classified as coughing and graded as mild (1-2), moderate (3-4) or severe (5 or more). We found that the overall incidence of cough was significantly higher in the saline group (69 patients; 27.6%) than that in the lidocaine group (38 patients; 15.2%) (p < 0.001). The results of logistic regression indicated that age and smoking were associated with remifentanil-induced cough. This study demonstrated that intravenously administered lidocaine 0.5 mg x kg(-1) effectively suppresses remifentanil-induced cough without possible systemic lidocaine toxicity.

Single-stage reconstruction of Achilles tendon injuries and distal lower extremity soft tissue defects with the reverse sural fasciocutaneous flap

OBJECTIVE

Complex wounds of the lower extremity with concomitant Achilles tendon injury can be difficult to reconstruct. We favour the reverse sural artery fasciocutaneous flap because in a single step, flap elevation affords Achilles tendon exposure and adequate soft tissue for reconstruction. It also provides significant time and resource savings for both plastic and orthopaedic surgical teams.

MATERIALS AND METHODS

Our case series involved four consecutive patients who presented with Achilles tendon injuries and concomitant complex soft tissue defects. The reverse sural artery flap was planned in conjunction with the orthopaedic service to facilitate their approach for Achilles tendon repair. Outcome was measured as flap survival, time for flap elevation and total operative time.

RESULTS

Partial flap loss occurred in one patient. The Achilles repair was performed successfully in all cases. The mean time for flap elevation and Achilles exposure was 43 min (range, 37-52 min). Total operative time was 287 min (range, 211-347 min).

CONCLUSION

The reverse sural artery fasciocutaneous flap is a durable, efficient option for simultaneous Achilles tendon reconstruction and wound coverage. Simple flap elevation provides necessary exposure of the Achilles tendon for repair while the flap itself provides ample soft tissue with a reliable blood supply. In our experience, the reverse sural artery fasciocutaneous flap affords a practical method to address two reconstructive challenges in a single procedure.

A cell culturing system that integrates the cell loading function on a single platform and evaluation of the pulsatile pumping effect on cells

In this paper, we present a novel microfluidic system with pulsatile cell storing, cell-delivering and cell culturing functions on a single PDMS platform. For this purpose, we have integrated two reservoirs, a pulsatile pumping system containing two soft check valves, which were fabricated by in situ photopolymerization, six switch valves, and three cell culture chambers all developed through a simple and rapid fabrication process. The sample volume delivered per stroke was 120 nl and the transported volume was linearly related to the pumping frequency. We have investigated the effect of the pulsatile pneumatic micropumping on the cells during transport. For this purpose, we pumped two types of cell suspensions, one containing human breast adenocarcinoma cells (MCF-7) and the other mesenchymal stem cells (hMSCs) derived from bone marrow. The effect of pulsatile pumping on both cell types was examined by short and long-term culture experiments. Our results showed that the characteristics of both cells were maintained; they were not damaged by the pumping system. Evaluations were carried out by morphological inspection, viability assay and immunophenotyping analysis. The delivered MCF-7 cells and hMSCs spread and proliferated onto the gelatin coated cell culture chamber. This total micro cell culture system can be applied to cell-based high throughput screening and for co-culture of different cells with different volume.